Aa
HVP Transmission
Doctor Hook,
Last week, I had a hemorroidectomy for stage 4 hemorroids. The hospital sent the removed tissue to a pathology lab for screening. Yesterday I was given the results, which includes high grade anal intraepithelial neoplsia (AIN II).
My surgeon told me that the AIN was caused by a virus, but he was not really knowledgeable about the subject except to tell me that it is not cancer (at this point, anyway), that he was not interested in my "lifestyle", and not much else. Doing my research last night, I discovered that the AIN is caued by HPV, and that HPV is transmitted by skin-to-skin contact.
I have never participated in MSM (most likely the "lifestyle" hinted by my surgeon), but in my research I discovered that HPV can be passed on by the fingers. For the past year, I have been pushing in the hemorroids manually after a BM. I believe that I infected myself with the HPV, but how do I root out the source?
Since my AIN is in stage II, how long would I have been in stage I? I think that's a wide, unknown timeframe, isn't it?
Should I have my wife make an appointment to be examined?
If the AIN progresses to carcinoma, what will be the early warning signs?
I probably have more questions, but that's what I can think of for now.
Thank you in advance.
Last week, I had a hemorroidectomy for stage 4 hemorroids. The hospital sent the removed tissue to a pathology lab for screening. Yesterday I was given the results, which includes high grade anal intraepithelial neoplsia (AIN II).
My surgeon told me that the AIN was caused by a virus, but he was not really knowledgeable about the subject except to tell me that it is not cancer (at this point, anyway), that he was not interested in my "lifestyle", and not much else. Doing my research last night, I discovered that the AIN is caued by HPV, and that HPV is transmitted by skin-to-skin contact.
I have never participated in MSM (most likely the "lifestyle" hinted by my surgeon), but in my research I discovered that HPV can be passed on by the fingers. For the past year, I have been pushing in the hemorroids manually after a BM. I believe that I infected myself with the HPV, but how do I root out the source?
Since my AIN is in stage II, how long would I have been in stage I? I think that's a wide, unknown timeframe, isn't it?
Should I have my wife make an appointment to be examined?
If the AIN progresses to carcinoma, what will be the early warning signs?
I probably have more questions, but that's what I can think of for now.
Thank you in advance.
MEDICAL PROFESSIONAL
Although your question was directed to Dr. Hook, we take them interchangably. There is never any significant disagreement among us.
Neither of us routinely provides care for persons in your situation. Patient with suspected anal intraepithelial neoplasia (AIN) in STD or infectious diseases clinics are routinely referred to proctologists or colon and rectal surgeons. Please take that into account in my responses below.
As your experience shows, anal warts and other HPV infections are not limited to men who have sex with men, although they are much more common in MSM. The exact mechanism of transmission hasn't been studied and isn't known, whether by fingers or by spread of genital secretions to the anal area during sex. Either is plausible.
The "stages" of pre-cancerous HPV lesions don't necessarily occur in sequence. Someone with stage II disease might have gone directly to that stage, without passing through stage I. It can happen any time from a few weeks after acquring HPV to years later. From the information you provide, there is no way to know how long you had your anal HPV infection.
Every woman should have annual pap smears. If your wife hasn't had a gynecologic exam and pap smear in the past year, she should do it now. Regardless of the result, you and she should assume she is infected (or has been infected in the past) with the same HPV strain that you have. But as long as her paps are normal and she has no other symptoms, there is no risk to hear health and no need for worry. Remember that the large majority of HPV infections, including those that are high risk for cancer, go away on their own without harm or risk.
Assuming the abnormal tissue has been excised, most likely your problem is gone. And even without surgical treatment, the large majority of AIN goes away, without progressing to cancer. In other words, if you had never had the hemorrhoids and had the AIN diagnosed, probably you would be safe. However, you should follow your surgeon's advice about whether periodic reexamination is necessary to stay ahead of any problem.
As to specific symptoms, most likely you would notice a growth near the anus, or perhaps bleeding. But the problem could progress without any symptoms at all. As I said, your surgeon might recommend periodic reexamination, e.g. to take a look inside with an anoscope once a year for a few years. But this is outside my and Dr. Hook's expertise.
I hope this helps. Best wishes-- HHH, MD
Neither of us routinely provides care for persons in your situation. Patient with suspected anal intraepithelial neoplasia (AIN) in STD or infectious diseases clinics are routinely referred to proctologists or colon and rectal surgeons. Please take that into account in my responses below.
As your experience shows, anal warts and other HPV infections are not limited to men who have sex with men, although they are much more common in MSM. The exact mechanism of transmission hasn't been studied and isn't known, whether by fingers or by spread of genital secretions to the anal area during sex. Either is plausible.
The "stages" of pre-cancerous HPV lesions don't necessarily occur in sequence. Someone with stage II disease might have gone directly to that stage, without passing through stage I. It can happen any time from a few weeks after acquring HPV to years later. From the information you provide, there is no way to know how long you had your anal HPV infection.
Every woman should have annual pap smears. If your wife hasn't had a gynecologic exam and pap smear in the past year, she should do it now. Regardless of the result, you and she should assume she is infected (or has been infected in the past) with the same HPV strain that you have. But as long as her paps are normal and she has no other symptoms, there is no risk to hear health and no need for worry. Remember that the large majority of HPV infections, including those that are high risk for cancer, go away on their own without harm or risk.
Assuming the abnormal tissue has been excised, most likely your problem is gone. And even without surgical treatment, the large majority of AIN goes away, without progressing to cancer. In other words, if you had never had the hemorrhoids and had the AIN diagnosed, probably you would be safe. However, you should follow your surgeon's advice about whether periodic reexamination is necessary to stay ahead of any problem.
As to specific symptoms, most likely you would notice a growth near the anus, or perhaps bleeding. But the problem could progress without any symptoms at all. As I said, your surgeon might recommend periodic reexamination, e.g. to take a look inside with an anoscope once a year for a few years. But this is outside my and Dr. Hook's expertise.
I hope this helps. Best wishes-- HHH, MD
I sincerely appreciate your reply; it helps to relieve my anxiety about all of this. At least I know what I am dealing with. I wish that there was more education on the male side of these subjects; perhaps there will be in the future.
Best Regards,
Hurtin' Puppy
Best Regards,
Hurtin' Puppy
You are reading content posted in the STDs Forum
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